Soft‐Wall Reconstruction of the Posterior External Ear Canal Wall

Abstract

A simple method of reconstructing a previously removed posterior ear canal with an autogenous, bilaminar membrane is described. The resulting air-filled mastoid cavity is an anatomic extension of the middle ear cleft and is separated from the ear canal by a functional barrier that is continuous with the tympanic membrane. The acoustic characteristics of an associated tympanoplasty are not significantly altered, and many of the problems that are associated with an exteriorized cavity are avoided. In contradistinction to other methods of mastoid obliteration or reconstruction, the semitransparent nature of the soft canal wall allows inspection of the underlying cavity for residual or recurrent disease. The technique can be used to repair either a newly created cavity or a previous radical (or modified radical) mastoidectomy defect. The functional results of thirty ears reconstructed in this fashion are detailed. A variable amount of soft-wall retraction was noted postoperatively in 47% of the ears; however, the long-term functional results in these cases remain satisfactory.

Postoperative Aeration in the Middle Ear and Hearing Outcome After Canal Wall Down Tympanoplasty With Soft-Wall Reconstruction for Cholesteatoma

“…CWD tympanoplasty with soft-wall reconstruction (SWR) is a unique technique first reported by Smith et al (8) in 1986 in which a piece of deep temporal fascia and fibrin glue are used to reconstruct the external auditory canal (EAC). This procedure provides a sufficient surgical view after CWD, a short additional operating time for reconstruction, quick postoperative epithelialization of the tympanic membrane (TM) and EAC skin, and restoration of the self-cleaning EAC (8Y10).…”

Factors affecting recovery of mastoid aeration after ear surgery

“…The patients (18 males and 38 females) ranged in age from 7 to 69 years, averaging 40.7 ± 17.2 years. In 13 of the 57 cases, the posterior bony wall of external auditory canal (EAC) was preserved, while in the remaining 44 cases it was removed and reconstructed using only the skin of EAC and temporal fascia [7,14]. In a period of up to 12 months after surgery, aeration in the mastoid cavity was determined by computed tomography (CT) using horizontal views in which the lateral semicircular canal could be seen most clearly.…”

Comparison of mastoid obliteration with middle temporal artery flap versus open cavity: a comparative study

“…Smith et al who first reported soft-wall reconstruction, reconstructed the defects of the tympanic membrane and posterior EAC wall after removing the cholesteatoma with free soft tissue, such as a piece of the deep temporal fascia, while preserving as much of the posterior EAC wall skin as possible. 6 Many other variations of soft tissue reconstruction of the canal wall have been tried since then with different benefits. But they are not without problems.…”